肠结核与克罗恩病、肠淋巴瘤的临床特点分析  

Differentiations clinical features of intestinal tuberculosis from, crohn＇ s disease and primary intestinal lymphoma

作　　者：曹卓[1] 陈明锴[1] 李瑾[2] 夏冰[2] 

机构地区：[1]武汉大学人民医院消化内科,430060 [2]武汉大学中南医院消化内科

出　　处：《临床内科杂志》2011年第7期471-474,共4页Journal of Clinical Internal Medicine

摘　　要：目的探讨肠结核（ITB）、克罗恩病（CD）和原发性肠淋巴瘤（PIL）的临床特点，以期发现对肠结核有鉴别意义的指标。方法回顾性分析2005年5月-2010年10月武汉大学人民医院和中南医院30例肠结核、38例克罗恩病、15例原发性肠淋巴瘤患者的病例资料。结果肠结核患者来自农村、首发腹痛、结核中毒症状、伴肠外结核、白蛋白下降、PPD强阳性、仅右半结肠受累及横行溃疡较克罗恩病多见；克罗恩病患者来自城市，首发大便改变、病程长且反复、肠壁增厚、直肠受累、节段性分布、纵形溃疡较肠结核多见。肠结核患者30岁以下者、纳差、乏力、溃疡形成较原发性肠淋巴瘤多见；原发性肠淋巴患者瘤肿块、肠穿孔、急诊手术、肠壁增厚、小肠受累、单节段受累较肠结核多见。差异均有统计学意义。结论肠结核与克罗恩病、原发性肠淋巴瘤各自有一定的特异性。获取详尽信息综合分析及诊断性治疗仍为肠结核鉴别诊断的核心。Objectives To compare the clinical,laboratory, radiological, and endoscopic features of Crohn＇ s disease （CD）, intestinal tuberculosis （ITB） and primary intestinal lympbema （ PIL ） in order to find out predictor features for differentiation between ITB and CD, as well as differentiation between ITB and PIL. Methods We recruited 83 patients between May 2005 and October 2010,30 with ITB,38 with CD and 15 with PIL. All their medical data were retrospectively analyzed. Results For the patients from the countryside, first symptom to abdominal pain, tuberculosis poisoning symptom, abenteric tuberculosis, hypoproteinemia,positive PPD and transverse ulcer were more common in ITB than CD. For the patients from cities, first symptom to a change in stool, long course of disease, thickening of intestinal wall, rectal involvement, skipping distribution and vertical ulcer were more common in CD than in ITB. Younger than 30, anorexia, fatigue and ulcers were more common in ITB than in PIL. Abdominal mass, intestinal perforation, emergent operation, thickening of intestinal wall and small intestine involvement were more common in PIL than in ITB. Conclusions There are some differences between ITB and CD, as well as between ITB and PIL. It is crucial for the differential diagnosis of intestinal tuberculosis to get adequate information about the patient＇s condition to analyze the disease comprehensively.

关 键 词：肠结核 克罗恩病 原发性肠淋巴瘤 诊断 鉴别 

分 类 号：R574[医药卫生—消化系统]